Xu R, Ebraheim N A, Yeasting R A, Jackson W T
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo. USA.
Spine (Phila Pa 1976). 1996 May 1;21(9):1017-20. doi: 10.1097/00007632-199605010-00004.
This study analyzed bony features of the posterior ilium and relevant vital structures using cadavers and dry ilium specimens.
To determine quantitatively the safely zone of the posterior ilium and relevant vital structures with regard to bone graft harvesting.
The most frequently used site for bone graft harvesting is the posterior ilium. However, complications related to posterior iliac bone harvesting, such as donor site pain, neurovascular injury, instability of the sacroiliac joint, and herniation of abdominal contents, are still major concerns. Very little research with regard to the quantitative study of the posterior ilium has been reported.
Six cadavers (four male, two female) were used for the first part of this study. The posterior superior iliac spine was determined as a reference landmark. The distances from the posterior superior iliac spine to the superior cluneal nerves, the gluteal line, and the superior gluteal vessels were measured. The second part of the study involved 30 adult, dry iliac bony specimens. The posterior iliac region (extra-articular portion) was divided into three zones, and the corresponding dimensions of these zones were measured.
The average distances from the posterior superior iliac spine to the superior cluneal nerves, gluteal line, and superior gluteal vessels were 68.8, 26.6, and 62.4 mm, respectively. The average width, height, and maximum thickness for Zone 1 were 34, 27.8, and 17.1 mm, respectively; the measurements for Zone 2 were 16.5, 31.8, and 14.2 mm, respectively. The average height for Zone 3 was 20.4 mm, and the average maximum thickness was 16.8mm.
The ideal area of the posterior ilium for bone graft harvesting was found in Zone 1. Zones 2 or 3 may be considered it a greater quantity of cancellous bone graft is required; however, the risk of injury to the sacroiliac joint and superior gluteal vessels in these zones is increased.
本研究使用尸体和干燥髂骨标本分析了髂骨后部的骨质特征及相关重要结构。
定量确定髂骨后部及相关重要结构在取骨时的安全区域。
最常用的取骨部位是髂骨后部。然而，与髂骨后部取骨相关的并发症，如供区疼痛、神经血管损伤、骶髂关节不稳定和腹腔内容物疝出，仍是主要问题。关于髂骨后部定量研究的报道很少。
本研究的第一部分使用了6具尸体（4男2女）。将髂后上棘确定为参考标志。测量从髂后上棘到臀上皮神经、臀线和臀上血管的距离。研究的第二部分涉及30个成人干燥髂骨标本。将髂骨后部区域（关节外部分）分为三个区域，并测量这些区域的相应尺寸。
从髂后上棘到臀上皮神经、臀线和臀上血管的平均距离分别为68.8、26.6和62.4毫米。区域1的平均宽度、高度和最大厚度分别为34、27.8和17.1毫米；区域2的测量值分别为16.5、31.8和14.2毫米。区域3的平均高度为20.4毫米，平均最大厚度为16.8毫米。
发现髂骨后部取骨的理想区域在区域1。如果需要更多的松质骨移植，可以考虑区域2或3；然而，这些区域中骶髂关节和臀上血管损伤的风险会增加。
